Skip to main content
PMC home page
British Medical Journal logoLink to British Medical Journal
. 1973 Aug 11;3(5875):317–320. doi: 10.1136/bmj.3.5875.317

Studies of Carbohydrate and Lipid Metabolism in Women Developing Hypertension on Oral Contraceptives

Bridgett Mason, Nigel Oakley, Victor Wynn
PMCID: PMC1586506  PMID: 4723812

Abstract

Metabolic studies in 100 women developing hypertension on combined oestrogen-progestogen oral contraceptives have been compared with similar studies in normotensive women on oral contraceptives, matched for age and duration of contraceptive use, and in women not taking contraceptives.

The metabolic changes known to be induced by oral contraceptives—impaired glucose tolerance, elevated blood pyruvate levels, and raised serum lipid concentrations—were found to be exaggerated in the matched hypertensive group, largely due to pronounced abnormalities in 33 subjects with diastolic blood pressures over 110 mm Hg.

Women developing severe hypertension were older, more obese, and of higher parity than those with mild hypertension and there was a high incidence of previous toxaemia of pregnancy in the hypertensive group.

The results show that in women on oral contraceptives changes in blood pressure and in metabolic functions tend to be correlated with one another, and are consistent with the hypothesis that oral contraception induces a primary biochemical effect whose expression in the individual is determined by intrinsic factors including genetic constitution, age, weight, and parity.

Full text

PDF
319

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adams P. W., Oakley N. W. Oral contraceptives and carbohydrate metabolism. Clin Endocrinol Metab. 1972 Nov;1(3):697–720. doi: 10.1016/s0300-595x(72)80040-9. [DOI] [PubMed] [Google Scholar]
  2. Briggs E., Mack A., Taylor L., Browning J., Naismith L., Wilson E., Weir R. J. Blood-pressure in women after one year of oral contraception. Lancet. 1971 Mar 6;1(7697):467–470. doi: 10.1016/s0140-6736(71)91087-7. [DOI] [PubMed] [Google Scholar]
  3. Catt K. J., Cran E., Zimmet P. Z., Best J. B., Cain M. D., Coghlan J. P. Angiotensin II blood-levels in human hypertension. Lancet. 1971 Mar 6;1(7697):459–464. doi: 10.1016/s0140-6736(71)91085-3. [DOI] [PubMed] [Google Scholar]
  4. Clezy T. M., Foy B. N., Hodge R. L., Lumbers E. R. Oral contraceptives and hypertension. An epidemiological survey. Br Heart J. 1972 Dec;34(12):1238–1243. doi: 10.1136/hrt.34.12.1238. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cramp D. G. Automated enzymatic fluorometric method for the determination of pyruvic and lactic acids in blood. J Clin Pathol. 1968 Mar;21(2):171–174. doi: 10.1136/jcp.21.2.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cramp D. G. New automated method for measuring glucose by glucose oxidase. J Clin Pathol. 1967 Nov;20(6):910–912. doi: 10.1136/jcp.20.6.910. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cramp D. G., Robertson G. The fluorometric assay of triglyceride by a semiautomated method. Anal Biochem. 1968 Oct 24;25(1):246–251. doi: 10.1016/0003-2697(68)90097-3. [DOI] [PubMed] [Google Scholar]
  8. Crane M. G., Harris J. J. Plasma renin activity and aldosterone excretion rate in normal subjects. II. Effect of oral contraceptive agents. J Clin Endocrinol Metab. 1969 Apr;29(4):558–562. doi: 10.1210/jcem-29-4-558. [DOI] [PubMed] [Google Scholar]
  9. DRAZIN M. L. Glucose tolerance in hypertension and obesity. Diabetes. 1953 Nov-Dec;2(6):433–442. doi: 10.2337/diab.2.6.433. [DOI] [PubMed] [Google Scholar]
  10. Di Paola G., Puchulu F., Robin M., Nicholson R., Marti M. Oral contraceptives and carbohydrate metabolism. Am J Obstet Gynecol. 1968 May 15;101(2):206–216. doi: 10.1016/0002-9378(68)90189-0. [DOI] [PubMed] [Google Scholar]
  11. Doar J. W., Wynn V. Effects of obesity, glucocorticoid, and oral contraceptive therapy on plasma glucose and blood pyruvate levels. Br Med J. 1970 Jan 17;1(5689):149–152. doi: 10.1136/bmj.1.5689.149. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hazzard W. R., Spiger M. J., Bagdade J. D., Bierman E. L. Studies on the mechanism of increased plasma triglyceride levels induced by oral contraceptives. N Engl J Med. 1969 Feb 27;280(9):471–474. doi: 10.1056/NEJM196902272800904. [DOI] [PubMed] [Google Scholar]
  13. Javier Z., Gershberg H., Hulse M. Ovulatory suppressants, estrogens, and carbohydrate metabolism. Metabolism. 1968 May;17(5):443–456. doi: 10.1016/0026-0495(68)90067-x. [DOI] [PubMed] [Google Scholar]
  14. Kunin C. M., McCormack R. C., Abernathy J. R. Oral contraceptives and blood pressure. Arch Intern Med. 1969 Apr;123(4):362–365. [PubMed] [Google Scholar]
  15. Laragh J. H. Oral contraceptives and hypertensive disease: a cybernetic overview. Circulation. 1970 Dec;42(6):983–985. doi: 10.1161/01.cir.42.6.983. [DOI] [PubMed] [Google Scholar]
  16. Newton M. A., Sealey J. E., Ledingham J. G., Laragh J. H. High blood pressure and oral contraceptives. Changes in plasma renin and renin substrate and in aldosterone excretion. Am J Obstet Gynecol. 1968 Aug 15;101(8):1037–1045. doi: 10.1016/0002-9378(68)90345-1. [DOI] [PubMed] [Google Scholar]
  17. PYKE D. A., PLEASE N. W. Obesity, parity and diabetes. Proc. Soc. Endocr. 60th. J Endocrinol. 1957 Jun;15(2):xxvi–xxxiii. [PubMed] [Google Scholar]
  18. Robertson G., Cramp D. G. An evaluation of cholesterol determinations in serum and serum lipoprotein fractions by a semi-automated fluorimetric method. J Clin Pathol. 1970 Apr;23(3):243–245. doi: 10.1136/jcp.23.3.243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Saruta T., Saade G. A., Kaplan N. M. A possible mechanism for hypertension induced by oral contraceptives. Diminished feedback suppression of renin release. Arch Intern Med. 1970 Oct;126(4):621–626. [PubMed] [Google Scholar]
  20. Skinner S. L., Lumbers E. R., Symonds E. M. Alteration by oral contraceptives of normal menstrual changes in plasma renin activity, concentration and substrate. Clin Sci. 1969 Feb;36(1):67–76. [PubMed] [Google Scholar]
  21. Spellacy W. N., Birk S. A. The effect of intrauterine devices, oral contraceptives, estrogens, and progestogens on blood pressure. Am J Obstet Gynecol. 1972 Apr 1;112(7):912–919. doi: 10.1016/0002-9378(72)90811-3. [DOI] [PubMed] [Google Scholar]
  22. Spellacy W. N., Buhi W. C., Spellacy C. E., Moses L. E., Goldzieher J. W. Glucose, insulin, and growth hormone studies in long-term users of oral contraceptives. Am J Obstet Gynecol. 1970 Jan 15;106(2):173–182. doi: 10.1016/0002-9378(70)90259-0. [DOI] [PubMed] [Google Scholar]
  23. Stokes T., Wynn V. Serum-lipids in women on oral contraceptives. Lancet. 1971 Sep 25;2(7726):677–680. doi: 10.1016/s0140-6736(71)92247-1. [DOI] [PubMed] [Google Scholar]
  24. Tyson J. E. Oral contraception and elevated blood pressure. Am J Obstet Gynecol. 1968 Mar 15;100(6):875–877. doi: 10.1016/s0002-9378(15)33594-8. [DOI] [PubMed] [Google Scholar]
  25. Walters W. A., Lim Y. L. Cardiovascular dynamics in women receiving oral contraceptive therapy. Lancet. 1969 Oct 25;2(7626):879–881. doi: 10.1016/s0140-6736(69)92332-0. [DOI] [PubMed] [Google Scholar]
  26. Weinberger M. H., Collins R. D., Dowdy A. J., Nokes G. W., Luetscher J. A. Hypertension induced by oral contraceptives containing estrogen and gestagen. Effects on plasma renin activity and aldosterone excretion. Ann Intern Med. 1969 Nov;71(5):891–902. doi: 10.7326/0003-4819-71-5-891. [DOI] [PubMed] [Google Scholar]
  27. Woods J. W. Oral contraceptives and hypertension. Lancet. 1967 Sep 23;2(7517):653–653. doi: 10.1016/s0140-6736(67)90690-3. [DOI] [PubMed] [Google Scholar]
  28. Wynn V., Doar J. W. Some effects of oral contraceptives on carbohydrate metabolism. Lancet. 1969 Oct 11;2(7624):761–765. doi: 10.1016/s0140-6736(69)90477-2. [DOI] [PubMed] [Google Scholar]
  29. Wynn V., Mills G. L., Doar J. W., Stokes T. Fasting serum triglyceride, cholesterol, and lipoprotein levels during oral-contraceptive therapy. Lancet. 1969 Oct 11;2(7624):756–760. doi: 10.1016/s0140-6736(69)90476-0. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES